RESUMO
Study of the clinical, laboratory and phenotypic characteristics of peripheral peripheral blood lymphocytes were carried out in 35 untreated patients with chronic lymphocytic leukemia [CLL] in addition to 32 age and sex matched apparently healthy controls. Results showed that these patients can be classified into two major subgroups: 33 B lineage CLL [94.3%] and 2 T-CLL [5.7%]. S mlg was positive in 87.9% of the B lineage CLL [94.3%] and 2 T-CLL [5.7%]. S mlg was positive in 87.9% of the B lineage cases, with typical weak immunofluorescence, and 12.1% lacked S mlg but had cytoplasmic Ig [cy Ig]. The most common S mlg expressed on the membrane of B-CLL lymphocytes was IgM sharing a single light chain with IgD [48.3] followed by IgM 34.5%. Monoclonal expression of membrane light chain K was more commonly expressed than Lambda light chain [69% versus 31%]. The median value of the T4/T8 ratio of peripheral blood lymphocytes in the B-lineage CLL group was significantly lower than that of the normal control group [P= 0.001]. A significant correlation between the decrease in T4/T8 ratio and the progression of the disease was observed [P= 0.05]. This immunologic profile supports the view that the B-CLL lymphocyte is an immature B cell blocked at an early stage of development, but later than pre-B cells that contain only cystoplasmic mu. In T-CLL the lymphocytes showed a mature T cell membrane phenotype and belonged to the so called T suppressor/cytotoxic subset CD2+CD8+CD4-. Serum immunoglobulins were found to be significantly reduced, also C3 and C4 were decreased in the CLL group. IgA was found to be decreased in 75%, IgG in 50% and IgM in 42.9% of the CLL cases, respectively. No correlation could be detected between Ig levels and clinical staging. Nevertheless a significant linear positive correlation between the levels of serum Igs and the helper/suppressor ratio was found in the CLL cases